Objective To investigate the reasonable and effective administration ofdexmedetomidine for thoracic surgery anesthesia.Methods Eighty ASA Ⅰ-Ⅱ patients,aged 18-60 years old scheduled for elective thoracotomy were randomly assigned to 4 groups(each 20 patients).Group A:dexmedetomidine before anesthesia induction + bupivacaine before closed thorax cavity.Group B:dexmedetomidine before anesthesia induction + dexmedetomidine and bupivacaine before closed thorax cavity.Group C:0.9％ sodium chloride before anesthesia induction + bupivacaine before closed thorax cavity.Group D:0.9％ sodium chloride before anesthesia induction + dexmedetomidine and bupivacaine before closed thorax cavity.Mean arterial pressure (MAP) and heart rate (HR) were measured before infusing dexmedetomidine or 0.9％ sodium chloride (T0),after infusing dexmedetomidine or 0.9％ sodium chloride (T1),instant time after intubation (T2) and 3 min after intubation (T3),5 min after intubation (T4).The scores of visual analogue scale(VAS) and the consumption of analgesics were compared.Results There was no significant difference including gender,age,weight and operation time among four groups (P ＞ 0.05).Compared with T0,MAP and HR were significantly decreased at T1 in group A and group B (P ＜ 0.05),and were significantly increased at T2 in group C and group D (P＜ 0.05).Respectively compared with group A and group B,MAP and HR were significantly increased at T2,T3 in group C and group D (P ＜ 0.05).The scores of VAS in group B [(2.47 ± 1.43) scores] and group D [(2.00 ± 1.68) scores] were lower than those in group A [(4.78 ± 1.26) scores] and group C [(4.88 ± 1.62) scores] after operation 12 h.The times of using postoperative analgesics in group B [(0.6 ± 0.4) times] and group D [(0.8 ± 0.1) times] were significantly less than those in group A [(1.3 ± 0.5) times]and group C [(1.5 ± 0.4) times] (P ＜ 0.05).Conclusions Intravenous dexmedetomidine before anesthesia induction can control the effect of double-lumen endobronchial tube responses and make hemodynamics stable.Intercostal nerve block with 0.5 μ g/kg bupivacaine and 0.375％ dexmedetomidine can enhance the analgesia effect and prolong the analgesia time.

Objective To observe the effect of intranasal dexmedetomidine on total intravenous anesthesia for thyroid surgery postoperative analgesia.Methods Sixty female patients who were undergoing elective thyroid surgery were enrolled.Patients by total intravenous anesthesia were randomized in mechanical sampling method to receive intranasal dexmedetomidine 1 μ g/kg (group Ⅰ,30 cases),or the same volume sodium chloride (group Ⅱ,30 cases) before anesthesia induction,then flurbiprofen 100 mg intravenous 10 min before surgery.The postoperative surgical pain was assessed utilizing visual analogue scale (VAS),and the postoperative pain of cough was assessed by comfort score (BCS) at 1,2,4,6,8,12,24 h after surgery,in addition,the adverse reactions were recorded.Results The VAS scores at 1,2,4,6,8,12 h in group Ⅰ were lower than those in group Ⅱ,and there were statistically significant (P ＜ 0.05).The BCS scores at 1,2,4,6,8 h in group Ⅰ were higher than those in group Ⅱ,and there were statistically significant (P ＜ 0.05).The nausea and dizziness morbidity in group Ⅰ were lower than those in group Ⅱ (8 cases vs.14 cases,6 cases vs.14 cases),and there were statistically significant (P ＜ 0.05).Eight patients were required supplemental analgesic within 12 h after surgery in group Ⅱ,which was more than that in group Ⅰ (0 case),and there was statistically significant (P ＜ 0.05).Conclusion Receive total intravenous anesthesia for thyroid surgery,the patients who are given intranasal dexmedetomidine 1 μ g/kg combined with flurbipmfen can reach satisfactory postoperative analgesia,decrease the nausea and dizziness morbidity,increase the comfortable degree.

Objective:To understand the attitudes of medical students to public elective courses of humanistic quality and the existing problems. Method:Questionnaires were used in 1 ~5 grade students in randomly selected five medical colleges in Guizhou. Results:Total 1000 questionnaires were sent out, 957 were received, the recovery rate was 95. 7%;817 valid questionnaires, the effective rate was 81. 7%. 75. 56% of the students supported for medical colleges and uni-versities setting up humanistic quality public elective courses, but 24. 44% had negative attitude. Conclusions:It's nec-essary to make efforts to improve the mind medical student's humanistic quality. From the perspective of serving students, school should improve medical college students' humanistic quality from various aspects.

Objective To study the hypnotic interaction between propofol and ketamine with isobologram. Methods Seventy-five ASA Ⅰ - Ⅱ patients (35 male, 40 female) aged 20-50 yr, weighing 40-80 kg, undergoing elective upper abdominal surgery were randomly divided into three equal groups of 25 patients : propofol group (P); ketamine group (K) and propofol-ketamine combination group (P/K), Each group was further divided into 5 subgroups. Propofol 0.8, 1.0, 1.25, 1.56 or 1.95 mg ? kg-1 was given in 5 propofol subgroups (P1-5 ) respectively. Ketamine 0.32, 0.40, 0.50, 0.63 or 0.78 mg?kg-1 was given in 5 ketamine subgroups (K1-5 ) respectively. Propofol /ketamine 0.45/0.15, 0.60/0.20, 0.80/0.29, 1.05/0.35 or 1.41/0.47 mg?kg-1 were given in the 5 propofol-ketamine combination subgroups (P/K1-5 ) respectively. Two minutes after drug administration the patients were asked to open their eyes. Failure to open eyes was taken as the start-point of hypnotic effect. If the patient failed to respond to verbal order twice consecutively, the patient was considered to be in the hypnotic state. When the patient in hypnotic state failed to respond to electric stimulation of certain intensity, the patient was considered to be in anesthetic state. ED50s of propofol, ketamine and P/K combination for hypnotic and anesthetic effect were calculated. Isobologram was drawn. ED50 and 95 % confidence limit of ketamine were plotted on the abscissa and of propofol on the ordinate. The ED50 s of the two drugs were connected. If the ED50 of P/K combination was located on the connecting line, the two drugs are additive, on the left side of the connecting line synergistic, on the right side of the connecting line antagonistic. SBP, DBP, HR, SpO2 and BIS were continuously monitored before, during and after drug administration. Results The ED50 s for hypnotic and anesthetic effect were : 1.15 mg? kg-1 and 1.59 mg? kg-1 in group P; 0.40 mg? kg-1 and 0.72 mg? kg-1 in ketamine group; 0.65/0.22 mg?kg-1 and 1.19/0.40 mg?kg-1 in P/K group. The deviation of the location of ED50 of P/K combination from the connecting line was statistically insignificant. There was no significant change in SBP and DBF after administration of drugs in P/K group. Conclusion The hypnotic and anesthetic interaction between propofol and ketamine was additive. In terms of hemodynamic stability, P/K combination was the best among the three groups.

Metabolic syndrome (MS)is a clinical syndrome featured by glucose and lipid metabolic disorders,hyper- tension and obesity etc.,whose key links are insulin resistance and abdominal obesity.MS is closely related with cor- onary atherosclerosis,every link of MS can lead to occurrence and development of atherosclerosis.The present arti- cle mainly stated research progress of the correlation between MS and coronary atherosclerosis in recent years.

Objective:To investigate the anti-inflammatory effect and safety of tranexamic acid in the perioperative period of total knee arthroplasty.Methods:Eighty patients who underwent primary unilateral total knee arthroplasty because of knee osteoarthritis in Anqing Hospital of Anhui Medical University from October 2018 to March 2020 were included in this study. They were divided into an observation group and a control group ( n = 40/group) according to whether they received tranexamic acid treatment. In the observation group, 1 g tranexamic acid was intravenously administered at 10 minutes before releasing tourniquet and once every 3 hours starting at 24 hours after surgery. In the control group, 100 mL 0.9% sodium chloride injection was identically administered. Before surgery, immediately after surgery, and 1, 2 and 3 days after surgery, interleukin-6 level, erythrocyte sedimentation rate and C-reactive protein level in the venous blood were compared between the observation and control groups. Coagulation function and lower extremity deep venous thrombosis in the two groups were monitored. Postoperative pain, nausea, vomiting and muscle strength were compared between the two groups. Results:There were no significant differences in age, gender, body mass index and Hospital for Special Surgery knee score between the two groups (all P > 0.05). Univariate analysis of variance revealed that there were significant differences in interleukin-6 level ( t1 = 9.364, t2 = 11.027, t3 = 11.068), erythrocyte sedimentation rate ( t1 = 20.94, t2 = 18.898, t3 = 22.797) and C-reactive protein level ( t1 = 14.079, t2 = 12.099, t3 = 23.416) between the two groups at 1, 2 and 3 days after surgery (all P < 0.05). Regression analysis revealed that the maximum differences in erythrocyte sedimentation rate ( β = 0.217, P = 0.038), interleukin-6 ( β = 0.143, P = 0.025) and C-reactive protein ( β = 0.032, P = 0.010) between before and after total knee arthroplasty in the observation group were significantly lower compared with the control group ( β > 0, P < 0.10). Moreover, the differences in erythrocyte sedimentation rate, interleukin-6 and C-reactive protein at 3 days after surgery were significantly lower compared with at the other time points studied. Before and after surgery, there was no significant difference in coagulation function between the two groups (both P > 0.05). Lower extremity deep venous thrombosis occurred in neither groups. The recovery of postoperative pain, nausea, vomiting, and muscle strength in the observation group was significantly superior to that in the control group (all P < 0.05). Conclusion:Application of tranexamic acid in primary unilateral total knee arthroplasty can effectively attenuate perioperative inflammatory reaction, reduce postoperative adverse reactions and promote functional recovery, which deserves clinical application.

AIM: To further investigate the role of PKARⅠ? in the growth-promoting effects of Shuanglong-Jiegu pill (SLJGP), a Chinese medicine, on cultured osteoblasts. METHODS: pcDNA-antiPKARⅠ?, a recombinant expressing the antisense sequence of PKARⅠ?, was constructed and transformed HFOB1.19 by lipofectin. MTT was undertaken to assess the cell growth with the treatment of high dosage of SLJGP containing serum. RESULTS: Antisense gene blocked the growth-promoting effects of SLJGP containing serum on HFOB1.19. CONCLUSION: The function of SLJGP is closely related to cAMP-dependent protein kinase A. [

Comparative Genomic Hybridization ; methods ; DNA ; Gene Expression Profiling ; methods ; Genetics, Medical ; methods ; Humans ; In Situ Hybridization, Fluorescence ; Oligonucleotide Array Sequence Analysis ; methods

Adenine ; adverse effects ; analogs & derivatives ; Fanconi Syndrome ; chemically induced ; Hepatitis B, Chronic ; drug therapy ; Humans ; Hypophosphatemia ; chemically induced ; Organophosphonates ; adverse effects ; Osteomalacia ; chemically induced

Aim To prepare sterically stabilized liposomes modified with chimeric TNT-3 monoclonal antibody (chTNT-3) and investigate their immunoreactivity and in vitro targeting. Methods An endgroup functionalized polyethylene glycol-lipid derivative (pyridylthiopropionoylamino-polyethylene glycolhydrogenated soy phosphatidylethanolamine, PDP-PEG-HSPE ) was synthesized and incorporated to sterically stabilized liposomes. After mild thiolysis of the PDP groups by dithiothreitol, liposomes were covalently linked with maleimide-derivatized chTNT-3 and formed sterically stabilized immunoliposomes.Coupling efficiency, antibody density, size distribution, immunoreactivity of chTNT-3-modified sterically stabilized liposomes (chTNT-3-SLs) and specific binding properties of the chTNT-3-SLs to fixed Raji cells were determined, separately. Results Higher initial Ab/PDP-PEG-HSPE molar ratios resulted in higher antibody density on the surface of liposomes but lower coupling efficiency. The optimal coupling efficiency of 71% was obtained while antibody density in liposome was 106 μg antibody/μmol phospholipids (as initial antibody/PDP-PEG-HSPE = 1: 10). The chTNT-3-SLs had a narrow size distribution after extrusion and the mean size of this immunoliposomes was (115 ± 33) nm. The immunoreactivity of chTNT-3 can be preserved after efficient attachment of maleimide-derivatized chTNT-3 to the surface of liposomes. But calculated per antibody concentration, the immunoreactivity of chTNT-3-SLs would obviously decrease compared to that of chTNT-3 or chTNT-3 derivatives. Significantly higher binding of chTNT-3-SLs to fixed Raji cells directed by chTNT-3 was obtained compared to other preparations in serial dilutions (P＜0.01). Conclusion chTNT-3-SLs prepared by PDP-PEG-HSPE method remained most immunoreactivity of chTNT-3 and was able to bind nuclear antigens in vitro.